Muscle strain and tension

A neck strain occurs when one or more fibres in your neck muscle or tendon stretch too far and tear. This injury varies in intensity depending on the size and location of the tear.

While a neck strain typically heals on its own within a few days or weeks, the pain may range from mild and achy to sharp and debilitating.

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What causes or predisposes you to strain?

  • Poor posture

Your neck muscles, tendons and other soft tissues can become overstretched when your head is held too far forward or tilted at an angle for too long. Some examples include being hunched over a computer for several hours and holding a phone between the ear and shoulder.

  • Working at a desk for too long without changing position
    Long periods of time spent slouching or hunched over a computer screen can lead to forwarding head posture, (where your head is positioned with your ears in front of your body's vertical midline), which places extra stress on your neck. Repeatedly looking straight down at a phone or tablet may also cause pain - this is commonly referred to as ‘text neck’.

  • Sleeping with your neck in a bad position

If your head is held at a bad angle or twists during the night, you may wake up with a stiff neck in the morning.

  • Jerking your neck during exercise

A collision during sports or turning your head in a repetitive manner, such as side to side while dancing or swimming, may lead to overuse of your neck muscles, tendons, and ligaments.

Symptoms of  neck muscle strain

  • Pain localised to your neck region

  • Pain that worsens with movement. You may feel painless during rest but sudden pain once your neck moves in a certain direction

  • Muscle spasm

  • Stiff neck

When should I seek medical help?

There are circumstances when neck pain might be caused or accompanied by serious issues. If such symptoms are present it’s best to seek immediate medical attention to avoid further complications:

  • Pain or stiffness does not go away after a few weeks

  • The pain is disturbing your sleep

  • Painkillers do not work

  • Your pain was caused by a major accident such as a traffic collision or a fall

  • Weakness, numbness, or tingling in your limbs

  • Previous history of cancer

  • If you have a fever, chills, or unexplained weight loss

Diagnosis

To diagnose any strain in your neck your doctor will take your case history and past medical history into account. They will also palpate (gently examine by touch) the area to establish the source. Range of motion is also tested by moving your head up, down, and rotating side to side.

If your medical history and/or physical exam suggest that something more serious than a muscle strain is causing any of the symptoms, more advanced diagnostic testing may be needed.

Treatment

Initial treatment for neck strain involves: 

  • Activity modification. Resting your neck and/or refraining from strenuous activities for a couple of days can give the muscle or tendon time to start healing and feeling better.

  • Ice and/or heat therapy. Apply ice within the first 48 hours of an injury to help reduce swelling. After 48 hours, heat or ice may be applied, depending on your preference.

  • Over-the-counter pain medication. Pain relievers, such as acetaminophen (e.g. Panadol) can relieve pain. Taking anti-inflammatory medicines, such as ibuprofen (e.g. Advil) or naproxen (e.g. Aleve), reduces inflammation.

If the pain persists you may also get: 

  • Physiotherapy. A physical therapy program that targets muscles in your neck that need to become stronger and more flexible

  • Manual manipulation. A trained medical professional may make manual adjustments to your cervical spine

  • Prescription medications. While rare, sometimes a neck strain may require a prescription medication to provide relief, e.g. muscle relaxants.

Recovering from non-specific neck pain

The recovery period normally depends on the extent of the strain/ sprain, individual factors, and the ability to remove aggravating activities. Many non-serious neck muscle strains can heal within a few days or a few weeks on their own, whereas more serious cases may take more time.

To prevent non-specific neck pain, you should try: 

  • Be mindful of the physical activities you do. If an activity causes pain - stop. Although it’s common to feel some pain after a workout, allow enough time to recover before your next workout.

  • Regularly do exercises to stretch, mobilize and strengthen your neck and shoulder muscles

  • Watch your posture. Sitting and standing up straight with your shoulders back helps keep your spine in neutral alignment.

  • Sleep well. Finding the right pillow, mattress, and sleep position can reduce the risk of waking up with neck pain.

  • Take breaks. Repetitive motions can lead to muscle strain, including in the neck. Taking breaks or alternating activities enables your muscles to rest and recover to avoid injury.

  • Avoid carrying heavy bags with straps over your shoulder.